Provider Demographics
NPI:1265768576
Name:KINSELLA, CHERYL LYNN GRAVE (RN, MSN, PNP)
Entity type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:LYNN GRAVE
Last Name:KINSELLA
Suffix:
Gender:
Credentials:RN, MSN, PNP
Other - Prefix:MS
Other - First Name:CHERYL
Other - Middle Name:LYNN
Other - Last Name:BURKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:220 ATHENS WAY # 240
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37228-1311
Mailing Address - Country:US
Mailing Address - Phone:833-208-7770
Mailing Address - Fax:
Practice Address - Street 1:3200 SOUTHWEST FWY STE 2100
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-7525
Practice Address - Country:US
Practice Address - Phone:833-208-7770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-20
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY383804363LP0200X
IL277001180363LP0200X
NC5020433363LP0200X
TN36921363LP0200X
FLAPRN11023989363LP0200X
OKR0131486363LP0200X
ARA006019363LP0200X
DCNP500017560363LP0200X
MO2003017719363LP0200X
TX1105800363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics